Rectal electrode



Dec. 26, 1939. B GLASS 2,184,642

RECTAL ELECTRODE Fileii Nov. 1; 1937 Patented Dec. 26, 1939 UNITEDSTATES PATENT OFFiCE 8 Claims.

This invention relates to an instrument for treating the prostate glandby electrically applying heat thereto.

Certain abnormal conditions of the prostate gland can be corrected bycausing an increase of the blood supply to the organ. This instrument isadapted to electrically apply heat to the prostate gland, therebycreating in it an active hyperemia in order that the increased amount ofblood thus caused to circulate through the organ may improve itscondition.

It is an object of this invention to provide an instrument capable ofeasy insertion into the lower portion of the rectum and at the same timehaving relatively movable electrically heated parts which, while theinstrument is in its inserted position in the rectum, are capable ofbeing positioned by adjustment in a superior manner, for moreeffectively applying to the prostate gland beneficial, electricallyproduced heat.

Another object of the invention is to provide, in combination with saidadjustable parts of the instrument a covering member of an elasticcharacter which will act in opposition to means for mechanicallyseparating or expanding'the heating parts of the instrument so as tofurnish a simplified means for regulating, as desired, the extent of theexpansion of the parts for applying the heat to the gland, as aforesaid.

Other objects and advantages of the invention relate to the provision ofa more easily sterilized instrument for the purpose stated, to safeguardagainst causing any electric shock to the patient during treatment, andto apply the heat from the instrument to the prostate gland in a moredirect and effective manner.

Speaking morespecifically, it is another object of the invention toprovide, in an instrument for treating the prostate gland, anarrangement of parts which may be adjusted in such a manner, afterinsertion into the rectum, as to form aseat or nest for said gland, thenest-forming parts being heated in such a manner as to more effectivelyapply the heat to all those portions of the gland to which access may behad from within the rectum.

Other objects, advantages and features of invention will hereinafterappear.

Referring to the accompanying drawing, which illustrates what is atpresent deemed to be a-preferred embodiment of the invention,

Fig. 1 is a perspective view of the applicator portion of the instrumentshowing the adjustable parts in an expanded condition, the coveringenvelope being omitted and the shank or handle portion being mostlybroken away, in order to contract the ,view.

Fig. 2 is a perspective view of the complete instrument, except that theelastic covering or envelope is absent. In this view the applicatorportion of the instrument is shown in the closed or contractedcondition.

Fig. 3 is a view like Fig. 1 except that the elastic envelope is inplace, the outlines of the parts covered by said envelope beingindicated by dotted lines.

Fig. 4 is a perspective view velope, separately shown. I

Fig. 5 is a View showing the instrument partly in plan and partly inlongitudinal midsection, the elastic envelope being omitted and one ofthe adjustable applicator arms being shown in a fully deflected orwidely opened position.

Fig. 6 is a sectional view of the electric switch and includes partselectrically connected therewith, parts of the flexible conductors beingbroken away to contract the view.

Referring in detail to the drawing, the main parts of the instrument arethe elongated, generally cylindrical body l0 having secured to its outer(when inserted) end a head ll furnished laterally with a current intakeextension l2, said body having at its opposite end a longitudinal, fixedextension or basal arm l3 which is mainly of the elastic enlocated atone side of the produced axis of said,

body, a pair of swingable arms l4 and I5 each of which has at itsattached end an offset flattened extension l6 fastened by a pivot pin Hto said body In adjacent to the juncture of the fixed arm l3 with saidbody, and a manually rotatable shaft l8 having a screw threadedconnection with an axial bore provided therefor in the body ID, theinner end portion of said shaft acting as a follower against shoulderportions l 9 of the arms l4 and I5 to swing saidarms farther apart.

The fixed arm or extension. l3 serves as a guide and stabilizer for theswingable arms l4 and Hi with which it cooperates, and therefore saidarm l3 may be termed the basal arm of the group of three arms all ofwhich cooperate to convey the ,1

desired amount of heat to the prostate gland.

Said fixed extension or basal arm l3 has a bluntly tapered terminalportion 20 furnished with a lateral rise or shoulder 2| which extendslaterally beyond the line of the axis of the body H] of the instrument;that is to say, if the axial line of the body lfl'were to be produced itwould pass through said shoulder. Owing to its shape and position saidterminal portion 20 of said extension l3 is adapted to serve as a pilotor guide which aids the operator in directing the instrument into therectal canal. When the instrument is in its inserted position the basalarm I3 stabilizes the applicator portion of the instrument enabling theoperator to contact the prostate with a steady pressure of the desiredamount.

In cross section, the extension I3 is of a semicircular shape throughoutits length up to a point adjacent to its shoulder 2|, thus providing aflat face across which the flat under sides of the swingable arms I4 andI5 may glide during their swinging movements. The pivoted end portionsof said arms I4 and I 5 are always in a position to rest to asubstantial extent upon the upper surface of the extension I3, becausesaid arms need not be arranged to swing outwardly any farther thanindicated by the position of the arm I5 in Fig. 5.

The body portion of the instrument, adjacent to its juncture withthebasal arm I3, is provided on each side with a transverse slot 25, andthe extensions I6, whereby the swingable arms are pivotally mounted, areloosely fitted within these two slots 25. The operating shaft I8 isfurnished with an operating head IBa. Said swingable arms, when in theirinswung positions, combine with the basal arm I3 to form a bluntly orroundly pointed body shaped as a somewhat slender ovoid for aconsiderable distance adjacent to its extremity, and therefore easilyinsertable into the rectum.

The body IQ of the instrument is shown furnished at its flattened outerend with a peripherally extended portion 26, and to this end of theinstrument is secured the head I I which has already been mentioned.Said head is of an approximately hemispherical shape and, by screws 27,is secured to said body in axial alinement therewith and with its fiatface abutting against the flat end portion of said body. Said head IIcarries current-receiving extension l2 furnished with terminals 28a and28b.

The instrument arms I3, I4 and I5, the body I0 and the head II are allpreferably made of a rubber-like composition such as Bakelite. The screwthreads I8b of the metal shaft I8 may cooperate with screw threads madein the Bakelite around the bore which receives said shaft.

The basal arm I3 is furnished along the midwidth of the greater portionof its length with a rather spacious recess or groove 3S, and the armsI4 and I5 are likewise provided, in their lower, flat faces, withspacious grooves 3| and 32. Each of these three grooves contains anelectric heating element which need not be described in detail as it maybe of any preferred well known kind. Two of these elements are lettered,the one in the basal arm I3 being designated 33 and the one in the armI5 being designated 34, it being understood that the construction in thearm I4 is the same. as in the arm I5.

Wires 43, 44, 45 and 46 are provided to convey the current to the threeheating elements which have been mentioned. In Fig. 5 the wires 43 and44 are broken away in order to disclose the shaft I8 between them. Thewires 45 and 46 pass under the shaft and connect to the element 33.Wires 43 and 45 connect with the terminal 28a (Fig. 2) and the wires 44and 46 connect to the terminal 28b. Wires 43 and 44 are both forked atthe point designated 50 in Fig. 5, so that a lead from each passes intoeach heating element.

The switch 5I shown in Fig. 6 is a regular on and off switch, but aresistance unit 55 is connected in, as shown, thus making the switch ameans of turning more or less current into the heating elements. If theswitch is off part of the current passes through the lead 55 and theremainder through the leads 5'! and 53, resistance unit 55, leads 59 and'60. Leads 51, 53, 59 and 65 are in series. If the switch is on thecurrent passes through lead 55 as before, but now it mainly travels fromlead 57 through the arms SI, 62 and the lead 60, this circuit havingmuch less resistance than the circuit through the resistance unit 55.Even when the switch is on some current passes through said unit 55.

The remaining details of the switch 5| will not be minutely described asthe construction of said switch is of a conventional kind. Said switchis furnished with a plug-in attachment 65 to connect with a currentsupply and with a current delivery attachment 6'5 connectable with theterminals 28a and 2812 (Fig. 2).

Before the instrument is inserted into the rectum the portion thereof tobe inserted is enveloped in a sack I0 (Fig. 3) of sheet rubber, theswingable arms I4 and I5 being at this time in their inswung positions.Owing to its elastic character said rubber sheet will yieldingly opposethe outward swing which the operator will give to said arms after theinstrument is inserted preparatory to applying the instrument to theprostate gland.

The space between the outswung arms I4 and I5, bounded at its outer endby the shoulder 2i of the basal arm 38, is of a triangular characterand, in combination with the applied rubber sheet III forms acomfortably lined nest for the prostate gland when the instrument is inits operative position. In this position the three electrically heatedarms I3, I4 and I5 are brought snugly up against the prostate, it beingunderstood that the. operator will rotatably adjust the screw-threadedshaft I8 to spread the arms I4 and I5 apart whatever distance may benecessary to fit the instrument over the accessible portion of theprostate of the patient being treated, the instrument thus being adaptedfor accommodation to prostate glands greatly varying in size.

. The rubber envelope Ill may be removed, cleaned and sterilized moreeasily than the entire instrument itself, if used without the shieldafforded by said envelope.

The rubber sheet III, in addition to serving as an automatic retractingmeans for the swingable arms I4 and I5, safeguards against any electricshock being given to the patient from possible contact of tissue withthe electric heating elements. Said sheet also keeps all fecal matterout of the applicator portion of the instrument.

Besides these useful functions said sheet safeguards against anyhemorrhoidal projection or intestinal fold becoming pinched between theswingable arms when they are swung in preparatory to withdrawing theinstrument after the heat has been applied to the prostate for thedesired length of time.

As is well known to physicians, the prostate lies in the pelvis incontact with the anterior or front surface of the rectum. The normalgland is about one and one-half inches wide at the base and itsposterior or back surface (the portion which is accessible fortreatment) is in the shape of a triangle with its apex directeddownward. Hence, when the instrument provided. by this invention isapplied to the prostate according to the foregoing instructions, theinstrument fits the gland well, the broadest part of the glandnestingbetween the most divergent parts of the swingable arms 14 and I5and the apex of the gland occupying the narrower space nearer thepivoted ends of said arms. In' other words, the two swingable arms ofthe-instrument may be spread out to form, in combination with the fixedportions thereof, a triangularly shaped nest corresponding closely tothe spaceoccupied by the two lateral lobes of the prostate, to which theheat is to be applied.

The spreading apart of the swingable arms also has the effect ofretaining the inserted -instrument in its proper operative position.

It should be understood that the present disclosure is for the purposeof illustration only and that this invention includes all modificationsand equivalents which fall within the scope of the subject matterclaimed.

What is claimed is:

1. In a treating instrument of the kind described, an elongated partlysemicircularly shaped body having at one end a longitudinal, fixedextension which is mainly located at one side of the produced axis ofsaid body, a pair of arms jointly providing a semicircularly shaped bodyswingably connected with the instrument adjacent to the juncture of saidfixed extension with said body, said arms also each having a shoulderportion spaced somewhat away from its pivotal mounting, means toadjustably swing said arms apart to the desired extent and mechanicallymaintain them in such outswung position, said means comprising amanually rotatable shaft extending longitudinally within said body andhaving a screw threaded connection therewith and an end portion actingas a follower against said shoulder portions of said arms to swing thelatter farther apart, the under side fiat faces of said arms andextension being contiguous, there being a groove in the fiat face ofsaid extension along the midwidth thereof across which the flat undersides of said swinging arms glide in their swinging movements, anelectrical heating element in said groove, and means to electricallyheat said heating element while the instrument is inserted in a humanrectum.

2. The subject matter of claim 1 and, an elastic sheet enveloping saidarms, said sheet offering a yieldable opposition to their aforesaidoutward swinging whereby to contract said arms when the shaft is rotatedin a direction to relieve its contact with said shoulder portions.

3. In a treating instrument of the kind described, an elongated bodyhaving at one end a longitudinal, fixed extension which is mainlylocated at one side of the produced axisof said body, a pair of armsswingably connected with the instrument adjacent to the juncture of saidfixed extension with said body, said arms also each having a shoulderportion spaced somewhat away from its pivotal mounting, means toadjustably swing said arms apart to the desired extent and mechanicallymaintain them in such outswung position, said means comprising amanually rotatable shaft extending longitudinally within said body andhaving a screw-threaded connection therewith, and an end portion actingas a follower against said shoulder portions of said arms to swing thelatter farther apart, an elastic sheet enveloping said arms, and meansto electrically heat said arms while the instrument is expanded whileinserted in a human rectum, said shaft being operable torelieveopposition to inswinging of said arms under the urge of saidsheet and the human tissues distended thereby,

duced axis of said body, said rise forming an abutment in advance of theouter end portions of said arms when the latter are in their 'inswungposi- 'tions'and serving as a pilot to aid the operator in directing theinstrument'in the rectal canal.

14;:[11 an instrument of 'the kind described "having a portioninsertable in" the body of a patient, a plurality of swingable armscarried by said insertable portion of the instrument, means comprisingelectrical heating elements located in the contiguous faces of said armsto maintain said arms heated while the instrument is inserted, means toswing said arms into a diverging relation-to each other and maintainthem in their outswung positions, said means comprising a manuallyrotatable shaft extending longitudinally within said instrument andhaving a sorewthreaded connection therewith, and an end portion actingas a follower against said arms to swing them farther apart, and a sheetof elastic material enveloping said arms and offering yieldableopposition to swinging them apart, a

portion of said heating means also heating by the heat of convection aportion of said sheet which is exposed thereto in the regions betweensaid arms in their diverging relation.

5. In an instrument of the kind described having a body portion,-a basalarm constituting a fixed elongation of said body portion,- said armhavinga semi-cylindrical portion, the flat lateral surface of which isapproximately in alinement with the axis of said body portion, therebeing a groove in said lateral surface along the mid-width thereof, anelectrical heating element located in said groove, a pair of outwardlyswingable arms pivoted to the instrument, the swinging movements ofwhich are both in a plane substantially parallel to said fiat surface ofsaid basal arm, said arms also each having a shoulder portion spacedsomewhat away from its pivotal mounting and a flat underside whichglides across the flat lateral face of said basal arm, there being alsoa groove in each of the flat underside faces of said swingable arms, anelectric heating element located in each of the latter grooves, saidbasal arm having an outer end portion which is rounded and tapered togive it penetrability and which is offset to such a position that itcooperates with the other arms, when the latter are sufficientlyoutswung, to form a triangularly shaped pocket in which the prostategland of a patient may be nested, means carried by the instrument toswing the arms of said pair outwardly, said means comprising a manuallyrotatableshaft extending longitudinallywithin said body and having ascrewthreaded connection therewith, and an end portion acting as afollower against said arms to swing them farther apart, and an elasticenvelope surrounding all of said arms and forming a lining for the nestfor the prostate gland.

6. The subject matter of claim 5 and, said envelope being of insulatingmaterial and said heating elements being connected by wiring toelectrically heat them. 1

'7. An instrument of the kind described having an elongated body portionand a basal arm projecting longitudinally from an end portion of saidapproximately the same plane as the fiat face of theadjacentsemi-cylindrical arm, two swingable armsto cooperate with saidbasal armto provide an extended surface for engagement with theprostate, said swingable arms each having a flattened attaching portionoperating in one of said slots and therein pivotally fastened, saidswingable arms also each having a shoulder portion spaced somewhat awayfrom its pivotal mounting, a manually rotatable shaft extendinglongitudinally within said body and having a screwthreaded connectiontherewith and an end portion abuttable against said shoulder portions ofsaid arms to swing the latter apart, and yielding means tending tomaintain said swingable arms intheir inswung positions.

8. The subject matter of claim 7 and, said yielding means consisting ofa rubber sheet which envelopes all of said arms.

EDWIN B. GLASS.

